The Efficacy of Ropivacaine Combined with Midazolam Tramadol or Fentanyl on Patient-controlled Epidural Analgesia

Objective: To compare the efficacy of Ropivacaine alone or combined with fentanyl , midazolam or tramadol during PCEA.Method: Eighty patients scheduled for abdominal hysterectomy under combined epidural and spinal anesthesia were randomly divided into four groups. Group A received 0.15% ropivacaine, group B 0.15% ropivacaine + fentanyl (2.5μg/ml ), group C 0.15% ropivacuine +midazolam(0.5mg /ml), group D 0.15% ropivacaine +tramadol(3mg/ml).PCEA parameters were a loading dose of 6ml , a bolus dose of 3ml , a lockout interval of 30 min and continuous infusion of 2ml/h. The total drug dosage was recorded for up to 24h after operation . The number of PCEA demand ,visual analogue pain scales (VAS), the incidence of nausea and vomiting , respiratory rate (RR) and mean arterial pressure (MAP) were measured at 4h ,8h , 12h and 24h postoperatively .Result :The total drug dosage, number of button pressed and VAS in group A were significantly higher than those in the other groups (P0.01) , which was the least in group D. There was a higher incidence of nausea and vomiting in group B.Conclusion:Ropivacaine combined with fentanyl, midazolam or tramadol use for PCEA produces higher quality of pain relief than Ropivacaine alone.